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Three studies that should make a difference to Australian health care

If policy makers want to improve the safety of surgery or improve the outcomes for elderly patients requiring hospital treatment, then recent research has provided some concrete evidence for how they can achieve this.

This and other research is highlighted in the latest edition of the HARC eBulletin released today by the Sax Institute. The bulletin aims to highlights recently published research that is relevant for Australian health care policy deliberations.

The overwhelming amount of research published makes it almost impossible for policy makers, clinicians and managers to judge its quality and relevance. For example, there are approximately 90 new randomised controlled trials published every day.

The media often reports on the studies that seem most sensational rather than those that are of greatest relevance for policy and practice. Here are three important recent studies that you mightn’t have heard about if you’d been relying on the media headlines:

How to reduce avoidable complications following surgery

A study published in the New England Journal of Medicine compared the rate of complications and death prior to and after the implementation of a 19 point surgical safety checklist, developed by the World Health Organisation, in eight hospitals around the world.

Postoperative complication rates fell at all sites after the introduction of the checklist, on average by 36%. The total in-hospital rate of death fell from 1.5% to 0.8%. This study provides strong evidence that implementing a surgical safety checklist reduces deaths and complications.

In response to this evidence and other factors, the UK National Patient Safety Agency has issued an alert requiring all healthcare organisations in England and Wales to implement the WHO Surgical Safety Checklist (adapted for England and Wales) for every patient undergoing a surgical procedure by 1 February, 2010.

How to better help the increasing numbers of geriatric patients

Elderly patients with acute medical disorders do better if admitted to specialist geriatric units rather than having conventional hospital care.

That’s according to a systematic review and meta-analysis published in the British Medical Journal, which found that for older patients (65 yrs+) with acute medical disorders, admission to acute geriatric units increased the likelihood of living at home at discharge and lowered the risk of functional decline compared with conventional hospital care.

Can telephone counselling help cancer patients?

A UK study involving 374 breast cancer patients at low risk of recurrence compared traditional hospital follow-up with telephone follow-up by specialist nurses.

The results, published in the British Medical Journal, suggest telephone follow-up could decrease the load on hospital clinics without detrimental effects on patient care. The authors conclude that telephone follow up care is “suitable for women at low to moderate risk of recurrence and those with long travelling distances or mobility problems and decreases the burden on busy hospital clinics”.

By highlighting rigorous and important studies like these, we aim to counterbalance the sensationalised science that, at times, dominates our public discourse.

*The HARC eBulletin is produced in by the Sax Institute partnership with the NSW Clinical Excellence Commission and the Greater Metropolitan Clinical Taskforce.

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    Greg Angelo
    Posted Wednesday, 25 March 2009 at 3:49 pm | Permalink

    Having read the check list (as a layman) I am absolutely staggered that the processes outlined in this checklist are not part of normal procedural risk management and every operating theatre operated by a competent medical staff. The procedures appear to operate on fundamental risk management principles and I would appreciate some appropriately medically trained person enlightening me as to why this WHO checklistis not normal basic practice.

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